For Office Use Only

                                        AGENT APPOINTMENT BY
                                        NONRESIDENT FIDUCIARY
         312 Eighth Avenue North
6 thFloor, William R. Snodgrass Building
    Nashville, TN 37243-0306

APPOINTMENT OF TENNESSEE SECRETARY OF STATE AS AGENT FOR
                     SERVICE OF PROCESS FOR NONRESIDENT FIDUCIARY
                                PURSUANT TO TCA §35-50-107

The undersigned, _______________________________________________, a nonresident per-
son, bank or trust company, wishing to act as a fiduciary in the State of Tennessee in confor-
mity with the laws thereof, hereby appoints the Secretary of State of the State of Tennessee
as the undersigned’s agent for service of process.

All process in any suit or proceeding against the undersigned may be served upon the Ten-
nessee Secretary of State in any action or proceeding relating to any trust, estate or matter
within this State in respect of which the undersigned is acting in a fiduciary capacity.

The undersigned agrees that any process against the undersigned, which is served upon the
Tennessee Secretary of State, shall be of the same legal force and validity as if served on the
undersigned.

It is understood that this appointment shall continue for as long as any liability shall remain
outstanding against the undersigned pertaining to any such matters.

The specific trust, estate or person for which the undersigned has been appointed as fidu-
ciary is:

                      ________________________________________
                      ________________________________________

The street address (including zip code) of the undersigned (to which all copies of legal pro-
cess should be addressed) is:

                      _________________________________________
                      _________________________________________
                      _________________________________________
                      _________________________________________

Executed this ______ day of _______________________, ______.

_____________________________________
(signature)
                                        Filing Fee $10.00

  SS-4512 (Rev. 9-01)                                                                      RDA 1764